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Details for: TOPOTECAN INJECTION

Company: SANDOZ CANADA INCORPORATED

DIN DIN name Active Ingredient(s) Strength Dosage Form Route of Administration
02390981TOPOTECAN INJECTIONTOPOTECAN (TOPOTECAN HYDROCHLORIDE)1 MG / MLSOLUTIONINTRAVENOUS
Search Reported Side Effects Report a Side Effect

Consumer Information

This information was provided by the drug’s manufacturer when this drug product was approved for sale in Canada. It is designed for consumers and care givers. It is a summary of information about the drug and will not tell you everything about the drug. Contact your doctor or pharmacist if you have any questions about the drug.

What the medication is used for

Topotecan Injection (topotecan hydrochloride) is used for treatment of:

  • ovarian cancer (metastatic) after failure of initial or subsequent therapy.
  • sensitive small cell lung cancer after failure of first-line chemotherapy (defined as recurrence at least 60 days after first-line chemotherapy).
What it does

Topotecan Injection helps destroy tumours. It acts on an enzyme (topoisomerase-I) to prevent growth of tumour cells.

When it should not be used

Do not take topotecan hydrochloride if:

  • you are hypersensitive (allergic) to topotecan or any of the other ingredients of Topotecan Injection;
  • you are pregnant or breast-feeding;
  • you have severe kidney disease;
  • results of your last blood test show that you are not able to receive Topotecan Injection (severe bone marrow depression). Your doctor will tell you.
What the medicinal ingredient is

The medicinal ingredient is topotecan hydrochloride.

What the non-medicinal ingredients are

The nonmedicinal ingredients consist of tartartic acid, water for injection, hydrochloric acid and/or sodium hydroxide may be added to adjust the pH.

What dosage form it comes in

Topotecan Injection (Concentrate sterile solution. Not for direct infusion) is supplied in a 4mg/4ml (free base) for single use, boxes of 5 vials.

Warnings and precautions

Serious Warnings and Precautions

Topotecan Injection should be administered under the supervision of a physician experienced in the use of cancer chemotherapeutic agents.

Possible serious side effects includes:

  • a decrease in the number of cells produced in your bone marrow (bone marrow suppression), especially a type of white blood cells called neutrophils (neutropenia).
  • bowel inflammation which may cause severe pain in your abdomen, with fever and a decrease in white blood cells which can potentially be fatal (neutropenic colitis).
  • Lung inflammation which may cause severe coughing, shortness of breath and fever which can potentially be fatal (interstitial lung disease).

BEFORE you use Topotecan Injection talk to your doctor or pharmacist if:

  • you are hypersensitive (allergic) to topotecan or any of the other ingredients in Topotecan Injection;
  • you are pregnant or breast-feeding;
  • results of your last blood test show that you are not able to receive topotecan hydrochloride, your doctor will tell you;
  • you have kidney disease.

Use of this Medicine During Pregnancy and Breast-Feeding:
You should not be given Topotecan Injection if you are pregnant or think you are pregnant.

Nursing Mothers:
Do not breast-feed if you are receiving Topotecan Injection. You should not restart breast-feeding until the doctor tells you it is safe.

Use in Children:
Use in children is not recommended as safety and effectiveness have not been established.

Effect on Ability to Drive and Use Machinery:
Topotcan Injection may make you feel tired. Do not drive or operate any tools or machines if you feel tired or weak.

Interactions with this medication

It is important that your doctor know about all your medications so that you get the best possible treatment. Tell your doctor about all the medicines you are taking including those you have bought without a prescription.

Proper use of this medication

Usual dose

The dose of topotecan hydrochloride which you will receive will be based on your body size (surface area) and the results of blood tests carried out before treatment.

The recommended dose of Topotecan Injection is 1.5 mg/m2 by intravenous infusion over 30 minutes daily for 5 consecutive days, starting on day one of a 21-day course. Prior to administration Topotecan Injection will be diluted further using either sodium chloride solution or dextrose solution. A minimum of four courses of topotecan injection is recommended.

Insufficient data are available in children to provide a dosage recommendation.

Handling and Disposal: Procedures for proper handling and disposal of anticancer drugs should be used. Several guidelines on this subject have been published

Remember: This medicine is for you. Only a doctor can prescribe it for you. Never give it to someone else. It may harm them even if their symptoms are the same as yours.

Overdose

If you think you have been given too much topotecan hydrochloride, contact your healthcare professional, hospital emergency department or regional Poison Control Centre right away, even if you do not have any symptoms.

Accidental overdosage may result in low blood pressure, fast heart rate and bleeding of the bowel.

Side effects and what to do about them

Like all medicines, topotecan hydrochloride can have side effects. The most common side effects with topotecan hydrochloride are:

  • temporary reduction in the amount of new blood cells produced by your body, particularly of a type of white blood cell which is important for your body to prevent and fight off an infection. In approximately 1 in 20 patients a serious infection is caught during treatment which can be fatal. If at any time during treatment you feel unwell or develop a temperature you should contact your doctor immediately;

  • you may become temporarily anemic and tired or take longer for a minor injury to stop bleeding. The reduction in the amount of blood cells lasts for only a few days, starting from approximately day 8 of each treatment cycle and lasting for about a week. In most cases the level of blood cells return to normal in time for the next cycle of treatment.

  • Gastrointestinal perforations (including life-threatening and fatal cases) have been reported with topotecan hydrochloride-treated patients. Your doctor will monitor you for the possibility of GI perforation if you experience symptoms of severe stomach pain, nausea, vomiting and/or bloody stool and will discontinue Topotecan Injection if you have an intestinal perforation.

Other possible side effects are:

  • nausea (feeling sick or queasy or having the urge to throw up)
  • vomiting (throwing up)
  • diarrhea (frequent and watery bowel movements)
  • fever
  • hair loss
  • stomach pain
  • constipation
  • swelling and pain of the mouth, tongue or gums
  • fatigue (tiredness)
  • weakness
  • anorexia (weight loss and loss of appetite)
  • feeling unwell
  • headache
  • coughing
  • shortness of breath
  • yellow skin (jaundice)
  • rash
  • itching sensation
  • mild pain and inflammation at the site of injection. Severe allergic reactions have been reported rarely
  • lung inflammation (interstitial lung disease) has been reported rarely. Signs include difficulty in breathing, severe cough and fever.

Several of these effects may occur during your treatment. If you notice any of these, or any other effects not mentioned in this leaflet between courses or when you leave hospital after treatment has finished, tell your doctor, nurse or pharmacist.

Serious side effects, how often they happen and what to do about them
Side Effect/Symptom Talk with your Doctor immediately
Very Common
Any sign of fever or infection, or any unexpected bruising or bleeding
Common
Serious infection; local symptoms such as sore throat or urinary problems (for example, a burning sensation when urinating, which may be caused by a urinary infection)
Uncommon
Immediate allergic reaction and symptoms such as swelling of the mouth, throat, difficulty in breathing, rash, hives, increased heart rate, and collapse.
Rare
Severe bleeding
Severe abdominal pain, fever and diarrhea (rarely with blood).
These could be signs of bowel inflammation (colitis)
Severe cough, shortness of breath, fever (interstitial lung disease) You are at an increased risk if you have had radiation treatment to your lungs, or have previously taken medicines that caused lung damage
Frequency not known (events from spontaneous reports)
Severe stomach pain, nausea, vomiting of blood, black or bloody stools. (Possible symptoms of gastrointestinal perforation)
Mouth sores, difficulty swallowing, abdominal pain, nausea, vomiting, diarrhoea, bloody stool which could be signs and symptoms of inflammation of the inner lining of the mouth, stomach and / or gut (mucosal inflammation).

This is not a complete list of side effects. For any unexpected effects while taking Topotecan Injection, contact your doctor or pharmacist.
How to store

Unopened vials of Topotecan Injection are stable until the date indicated on the package when stored between 2 and 8ºC in a refrigerator and keep the container in the outer carton.

Diluted Solutions
If not used immediately, the diluted solution should be stored in a refrigerator between 2 and 8ºC protected from light, up to 24 hours and in line with good pharmaceutical practice.

Keep out of reach of children.

Reporting side effects

You can report any suspected side effects associated with the use of health products to Health Canada by:

NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

More information

This document, plus the full Product Monograph prepared for health professionals, can be obtained by contacting the sponsor, Sandoz Canada Inc., at: 1-800-361-3062
or
by written request at:
145, Jules-Léger
Boucherville, (QC), Canada
J4B 7K8

or by e-mail at :
medinfo@sandoz.com

This leaflet was prepared by Sandoz Canada Inc.

Last revised: March 29, 2019

Date modified: